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First Trimester Anomaly Scan Using Virtual Reality (VR FETUS Study): Study Protocol for a Randomized Clinical Trial C
Pietersma et al. BMC Pregnancy and Childbirth (2020) 20:515 https://doi.org/10.1186/s12884-020-03180-8 STUDY PROTOCOL Open Access First trimester anomaly scan using virtual reality (VR FETUS study): study protocol for a randomized clinical trial C. S. Pietersma1, A. G. M. G. J. Mulders1, L. M. Moolenaar1, M. G. M. Hunink2,3,4, A. H. J. Koning5, S. P. Willemsen6, A. T. J. I. Go1, E. A. P. Steegers1 and M. Rousian1* Abstract Background: In recent years it has become clear that fetal anomalies can already be detected at the end of the first trimester of pregnancy by two-dimensional (2D) ultrasound. This is why increasingly in developed countries the first trimester anomaly scan is being offered as part of standard care. We have developed a Virtual Reality (VR) approach to improve the diagnostic abilities of 2D ultrasound. Three-dimensional (3D) ultrasound datasets are used in VR assessment, enabling real depth perception and unique interaction. The aim of this study is to investigate whether first trimester 3D VR ultrasound is of additional value in terms of diagnostic accuracy for the detection of fetal anomalies. Health-related quality of life, cost-effectiveness and also the perspective of both patient and ultrasonographer on the 3D VR modality will be studied. Methods: Women in the first trimester of a high risk pregnancy for a fetus with a congenital anomaly are eligible for inclusion. This is a randomized controlled trial with two intervention arms. The control group receives ‘care as usual’: a second trimester 2D advanced ultrasound examination. The intervention group will undergo an additional first trimester 2D and 3D VR ultrasound examination. -
N35.12 Postinfective Urethral Stricture, NEC, Female N35.811 Other
N35.12 Postinfective urethral stricture, NEC, female N35.811 Other urethral stricture, male, meatal N35.812 Other urethral bulbous stricture, male N35.813 Other membranous urethral stricture, male N35.814 Other anterior urethral stricture, male, anterior N35.816 Other urethral stricture, male, overlapping sites N35.819 Other urethral stricture, male, unspecified site N35.82 Other urethral stricture, female N35.911 Unspecified urethral stricture, male, meatal N35.912 Unspecified bulbous urethral stricture, male N35.913 Unspecified membranous urethral stricture, male N35.914 Unspecified anterior urethral stricture, male N35.916 Unspecified urethral stricture, male, overlapping sites N35.919 Unspecified urethral stricture, male, unspecified site N35.92 Unspecified urethral stricture, female N36.0 Urethral fistula N36.1 Urethral diverticulum N36.2 Urethral caruncle N36.41 Hypermobility of urethra N36.42 Intrinsic sphincter deficiency (ISD) N36.43 Combined hypermobility of urethra and intrns sphincter defic N36.44 Muscular disorders of urethra N36.5 Urethral false passage N36.8 Other specified disorders of urethra N36.9 Urethral disorder, unspecified N37 Urethral disorders in diseases classified elsewhere N39.0 Urinary tract infection, site not specified N39.3 Stress incontinence (female) (male) N39.41 Urge incontinence N39.42 Incontinence without sensory awareness N39.43 Post-void dribbling N39.44 Nocturnal enuresis N39.45 Continuous leakage N39.46 Mixed incontinence N39.490 Overflow incontinence N39.491 Coital incontinence N39.492 Postural -
GMEC) Strategic Clinical Networks Reduced Fetal Movement (RFM
Greater Manchester & Eastern Cheshire (GMEC) Strategic Clinical Networks Reduced Fetal Movement (RFM) in Pregnancy Guidelines March 2019 Version 1.3a GMEC RFM Guideline FINAL V1.3a 130619 Issue Date 15/02/2019 Version V1.3a Status Final Review Date Page 1 of 19 Document Control Ownership Role Department Contact Project Clinical Lead Manchester Academic Health [email protected] Science Centre, Division of Developmental Biology and Medicine Faculty of Biology, Medicine and Health, The University of Manchester. Project Manager GMEC SCN [email protected] Project Officer GMEC SCN [email protected] Endorsement Process Date of Presented for ratification at GMEC SCN Maternity Steering Group on:15th February ratification 2019 Application All Staff Circulation Issue Date: March 2019 Circulated by [email protected] Review Review Date: March 2021 Responsibility of: GMEC Maternity SCN Date placed on March 2019 the Intranet: Acknowledgements On behalf of the Greater Manchester and Eastern Cheshire and Strategic Clinical Networks, I would like to take this opportunity to thank the contributors for their enthusiasm, motivation and dedication in the development of these guidelines. Miss Karen Bancroft Maternity Clinical Lead for the Greater Manchester & Eastern Cheshire SCN GMEC RFM Guideline FINAL V1.3a 130619 Issue Date 15/02/2019 Version V1.3a Status Final Review Date Page 2 of 19 Contents 1 What is this Guideline for and Who should use it? ......................................................................... 4 2 What -
ANC Level 1 2Nd Edition.Pdf
Pregnancy & Childbirth Management Guidelines Level- 1 A Guide for Nurses, Midwives and Doctors Second Edition DEPARTMENT OF WOMAN &CHILD HEALTH DIRECTORATE GENERAL OF PRIMARY HEALTH CARE MINISTRY OF HEALTH SULTANATE OF OMAN 2016 ML- 60 Pregnancy & Childbirth Management Guidelines Level- 1 A Guide for Nurses, Midwives and Doctors Second Edition 2016 I II ACKNOWLEDGEMENT Acknowledgement with gratitude to all contributors & Reviewers for their effort in updating this guideline manual: Contributors from Woman & Child Health Department: • Dr. Jamila Al-Abri, Senior Specialist, Dept. of Woman & Child Health • Dr. Fatima Al Hinai, Senior Specialist, Director of Woman & Child Health Dept. • Dr. Nawal Al Rashdi, Senior Specialist, Dept. of Woman & Child Health • Dr. Salwa Jabbar Alshahabi, Specialist, Dept. of Woman & Child Health • Dr. Omaima Abdel Wahab, Senior Medical Officer, Dept. of Woman & Child Health. Contributors from Primary Health Care Institutions: • Dr. Nabila Al Wahaibi, Senior Consultant (FAMCO), Wadi Kabeer Health Centre. • Dr. Ahdab Abdul Hafeez, Specialist, Muscat Health Centre. • Dr. Imrana Masoud, Senior Medical Officer, Al Seeb Health Centre. Contributors from National Diabetic & Endocrine Centre & NCD department • Dr. Noor Al Busaidi, Senior Consultant, Director of National Diabetic & Endocrine Centre (NDEC) • Dr. Hilal Al Musailhi, Senior Consultant Adult Endocrinology, (NDEC). • Dr. Deepa Manoharan , Medical Officer, (NDEC). • Dr. Nada Hareb Al Sumri, Senior Specialist, Non Communicable Disease Dept • Dr. Suleiman Al Shereigi, Senior Specialist in Public Health Administration,(NDEC) Reviewers from Secondary & Tertiary Heath Care : • Dr. Tamima Al Dughaishi, Senior Consultant Obstetrics & Gynecology, SQUH • Dr. Bernadette Punnoose, Senior Consultant Obstetrics & Gynecology, Royal Hospital • Dr. Badrya Al Fahdi, Senior Consultant Obstetrics & Gynecology, Royal Hospital • Dr. Sumaya Al Amri, Senior Specialist Obstetrics & Gynecology, Royal Hospital • Dr. -
Prenatal Ultrasonography of Craniofacial Abnormalities
Prenatal ultrasonography of craniofacial abnormalities Annisa Shui Lam Mak, Kwok Yin Leung Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong SAR, China REVIEW ARTICLE https://doi.org/10.14366/usg.18031 pISSN: 2288-5919 • eISSN: 2288-5943 Ultrasonography 2019;38:13-24 Craniofacial abnormalities are common. It is important to examine the fetal face and skull during prenatal ultrasound examinations because abnormalities of these structures may indicate the presence of other, more subtle anomalies, syndromes, chromosomal abnormalities, or even rarer conditions, such as infections or metabolic disorders. The prenatal diagnosis of craniofacial abnormalities remains difficult, especially in the first trimester. A systematic approach to the fetal Received: May 29, 2018 skull and face can increase the detection rate. When an abnormality is found, it is important Revised: June 30, 2018 to perform a detailed scan to determine its severity and search for additional abnormalities. Accepted: July 3, 2018 Correspondence to: The use of 3-/4-dimensional ultrasound may be useful in the assessment of cleft palate and Kwok Yin Leung, MBBS, MD, FRCOG, craniosynostosis. Fetal magnetic resonance imaging can facilitate the evaluation of the palate, Cert HKCOG (MFM), Department of micrognathia, cranial sutures, brain, and other fetal structures. Invasive prenatal diagnostic Obstetrics and Gynaecology, Queen Elizabeth Hospital, Gascoigne Road, techniques are indicated to exclude chromosomal abnormalities. Molecular analysis for some Kowloon, Hong Kong SAR, China syndromes is feasible if the family history is suggestive. Tel. +852-3506 6398 Fax. +852-2384 5834 E-mail: [email protected] Keywords: Craniofacial; Prenatal; Ultrasound; Three-dimensional ultrasonography; Fetal structural abnormalities This is an Open Access article distributed under the Introduction terms of the Creative Commons Attribution Non- Commercial License (http://creativecommons.org/ licenses/by-nc/3.0/) which permits unrestricted non- Craniofacial abnormalities are common. -
Fetal Medicine August 2010
Advanced Training Skills Module – Fetal Medicine August 2010 Fetal Medicine This module is designed to prepare the future consultant for dealing with congenital abnormalities detected during pregnancy. This includes the organisation and supervision of screening programmes for structural and chromosomal anomalies. Many of these cases need to be managed within a multidisciplinary team which includes clinical geneticists and fetal medicine subspecialists. Apart from a sound knowledge of embryology and fetal physiology, clinicians working in this field must be competent in the prenatal diagnosis of common abnormalities. They also require a sound working knowledge of clinical and laboratory genetics in order that they can investigate and, where appropriate, refer suitable families. Competence in obstetric ultrasound is a prerequisite for advanced skills in prenatal diagnosis and fetal medicine. Trainees must complete the new Intermediate Ultrasound of Fetal Anatomy module prior to entry into the ATSM in Fetal Medicine. Attendance at a suitable Fetal Medicine theoretical course is a compulsory requirement of the module. This must be attended before completion of the ATSM and can have been done not more than three years previously. Specifically, once trained, individuals should: Work well as part of a multidisciplinary team Understand the organization of prenatal screening and diagnostic services at a local and regional level Be clinically competent in the prenatal diagnosis, counselling and management of common fetal abnormalities and markers of chromosomal abnormality. Be clinically competent and certified in first trimester screening for chromosomal abnormality by a combination of nuchal translucency assessment and biochemical marker assays. Be clinically competent at amniocentesis and have a sound knowledge of the principles and techniques of first trimester chorion villus biopsy. -
Subset of Alphabetical Index to Diseases and Nature of Injury for Use with Perinatal Conditions (P00-P96)
Subset of alphabetical index to diseases and nature of injury for use with perinatal conditions (P00-P96) SUBSET OF ALPHABETICAL INDEX TO DISEASES AND NATURE OF INJURY FOR USE WITH PERINATAL CONDITIONS (P00-P96) Conditions arising in the perinatal period Conditions arising—continued - abnormal, abnormality—continued Note - Conditions arising in the perinatal - - fetus, fetal period, even though death or morbidity - - - causing disproportion occurs later, should, as far as possible, be - - - - affecting fetus or newborn P03.1 coded to chapter XVI, which takes - - forces of labor precedence over chapters containing codes - - - affecting fetus or newborn P03.6 for diseases by their anatomical site. - - labor NEC - - - affecting fetus or newborn P03.6 These exclude: - - membranes (fetal) Congenital malformations, deformations - - - affecting fetus or newborn P02.9 and chromosomal abnormalities - - - specified type NEC, affecting fetus or (Q00-Q99) newborn P02.8 Endocrine, nutritional and metabolic - - organs or tissues of maternal pelvis diseases (E00-E99) - - - in pregnancy or childbirth Injury, poisoning and certain other - - - - affecting fetus or newborn P03.8 consequences of external causes (S00-T99) - - - - causing obstructed labor Neoplasms (C00-D48) - - - - - affecting fetus or newborn P03.1 Tetanus neonatorum (A33) - - parturition - - - affecting fetus or newborn P03.9 - ablatio, ablation - - presentation (fetus) (see also Presentation, - - placentae (see also Abruptio placentae) fetal, abnormal) - - - affecting fetus or newborn -
Mortality Perinatal Subset, 2013
ICD-10 Mortality Perinatal Subset (2013) Subset of alphabetical index to diseases and nature of injury for use with perinatal conditions (P00-P96) Conditions arising in the perinatal period Note - Conditions arising in the perinatal period, even though death or morbidity occurs later, should, as far as possible, be coded to chapter XVI, which takes precedence over chapters containing codes for diseases by their anatomical site. These exclude: Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) Endocrine, nutritional and metabolic diseases (E00-E99) Injury, poisoning and certain other consequences of external causes (S00-T99) Neoplasms (C00-D48) Tetanus neonatorum (A33 2a) A -ablatio, ablation - - placentae (see alsoAbruptio placentae) - - - affecting fetus or newborn P02.1 2a -abnormal, abnormality, abnormalities - see also Anomaly - - alphafetoprotein - - - maternal, affecting fetus or newborn P00.8 - - amnion, amniotic fluid - - - affecting fetus or newborn P02.9 - - anticoagulation - - - newborn (transient) P61.6 - - cervix NEC, maternal (acquired) (congenital), in pregnancy or childbirth - - - causing obstructed labor - - - - affecting fetus or newborn P03.1 - - chorion - - - affecting fetus or newborn P02.9 - - coagulation - - - newborn, transient P61.6 - - fetus, fetal 1 ICD-10 Mortality Perinatal Subset (2013) - - - causing disproportion - - - - affecting fetus or newborn P03.1 - - forces of labor - - - affecting fetus or newborn P03.6 - - labor NEC - - - affecting fetus or newborn P03.6 - - membranes -
Chapter III: Case Definition
NBDPN Guidelines for Conducting Birth Defects Surveillance rev. 06/04 Appendix 3.5 Case Inclusion Guidance for Potentially Zika-related Birth Defects Appendix 3.5 A3.5-1 Case Definition NBDPN Guidelines for Conducting Birth Defects Surveillance rev. 06/04 Appendix 3.5 Case Inclusion Guidance for Potentially Zika-related Birth Defects Contents Background ................................................................................................................................................. 1 Brain Abnormalities with and without Microcephaly ............................................................................. 2 Microcephaly ............................................................................................................................................................ 2 Intracranial Calcifications ......................................................................................................................................... 5 Cerebral / Cortical Atrophy ....................................................................................................................................... 7 Abnormal Cortical Gyral Patterns ............................................................................................................................. 9 Corpus Callosum Abnormalities ............................................................................................................................. 11 Cerebellar abnormalities ........................................................................................................................................ -
Instructions / સૂચના Candidate Must Ensure Compliance to the Instructions Mentioned Below, Else Objections Shall Not Be Considered:
ANK PROVISIONAL ANSWER KEY [CBRT] Name of The Post Associate Professor, Obstetrics and Gynaecology, General State Service, (Special Recruitment) ,Class-1 | Advertisement No 57/2019-20 Preliminary Test Held On 24-02-2021 Que. No. 001-200 Publish Date 25-02-2021 Last Date to Send Suggestion (S) 05-03 -2021 Instructions / સૂચના Candidate must ensure compliance to the instructions mentioned below, else objections shall not be considered: - (1) All the suggestion should be submitted in prescribed format of suggestion sheet Physically. (2) Question wise suggestion to be submitted in the prescribed formatr (Suggestion rSheet) published on the website.r r (3) All suggestions are to be submitted with reference to the Maste Question Pape withr provisional answe key (Maste Question Paper), published herewith on the website. Objections should be sent referring to the Question, rQuestion No. & options ofr the Maste Question Paper. (4) Suggestions regarding question nos. and options othe than provisional answe key (Master Question Paper) shall not be considered. r (5) Objections and answers suggestedr by the candidate should be in compliance with the responses givenr by him in his answe sheet. Objections shall not be considered, r in case, if responses given in the answe sheet /response sheet and submitted suggestions are differed. (6) Objection fo each question shall be made on separate sheet. Objection fo more than one question in single sheet shall not be considered & treated as cancelled. ઉમેદવાર ે નીચેની સૂચનાઓનું પાલન કરવાની તકેદારી રાખવી, અયથા વાંધા-સૂચન અંગે કર ેલ રજૂઆતો યાને લેવાશે નહીં (1) ઉમેદવારે વાંધા-સૂચનો િનયત કરવામાં આવેલ વાંધા-સૂચન પકથી રજૂ કરવાના રહેશે. -
Prenatal Prediction of Outcome by Fetal Gastroschisis in a Tertiary Referral Center
diagnostics Article Prenatal Prediction of Outcome by Fetal Gastroschisis in a Tertiary Referral Center Katharina Nitzsche 1, Guido Fitze 2, Mario Rüdiger 3 and Cahit Birdir 1,* 1 Department of Obstetrics and Gynecology, University Clinic of Carl Gustav Carus Dresden, Technische Universität Dresden, 01307 Dresden, Germany; [email protected] 2 Department of Pediatric Surgery, University Clinic of Carl Gustav Carus Dresden, Technische Universität Dresden, 01307 Dresden, Germany; guido.fi[email protected] 3 Department of Pediatrics, University Clinic of Carl Gustav Carus Dresden, Technische Universität Dresden, 01307 Dresden, Germany; [email protected] * Correspondence: [email protected] Received: 4 June 2020; Accepted: 30 July 2020; Published: 30 July 2020 Abstract: The aim of this study was to find a prenatal parameter to be able to predict possible prenatal complications or postnatal surgical options, thus allowing the fetal medicine specialist, together with pediatric surgeons and neonatologists, to improve the counseling of the parents and to determine the timing of delivery and therapy. This was a retrospective analysis of prenatal diagnosis and outcome of fetuses with 34 cases of gastroschisis between the years 2007 and 2017. A total of 34 fetuses with gastroschisis were examined and 33 outcomes registered: 22 cases of simple gastroschisis (66.7%) and 11 cases of complex gastroschisis (33.3%). A cut-off value of 18 mm for intraabdominal bowel dilatation (IABD) showed a positive predictive value (PPV) of 100% for predicting simple gastroschisis. IABD gives the best prediction for simple versus complex gastroschisis (cut-off of 18 mm). Extra-abdominal bowel dilatation (EABD) cut-off values of 10 mm and 18 mm showed low sensitivity and specificity to predict complex gastroschisis. -
Parturitional Brain Injury Definition of Parturitional Injury
Parturitional Brain Injury Definition of parturitional injury Thierry A.G.M. Huisman, MD • Any condition that affects the fetus adversely Director Pediatric Radiology and Pediatric Neuroradiology Johns Hopkins Hospital during labor and delivery • May be caused by: – Hypoxia and infection (birth injury) – Mechanical forces (birth trauma) Definition of parturitional injury Introduction • Life starts with a mechanical trauma – Squeezed together by a muscular wrapping • Any condition that affects the fetus adversely – Pushed through a narrow, bony canal with multiple bumps during labor and delivery – Getting your neck extended, rotated and pulled – Life line (umbilical cord) may be compressed – Possibly additional “medieval” instrumentation • May be caused by: – All of this for many minutes or even hours – Hypoxia and infection (birth injury) – Mechanical forces (birth trauma) Introduction Introduction • Life starts with a mechanical trauma • Life starts with a “stress” trauma – Or even worse, within minutes you are squeezed – And than suddenly lots of light, noise and many and “ejected” crying/emotional people around you,…. 1 Subjects who try to relive the „Scientific approach” “I am stuck feeling” Tortuguero expedition. www.philsheldon.wordpress.com Guettler FV, et al. Magnetic resonance imaging of the active second stage of labour: Proof of principle Eur Radiol 2012;22:2020-2026 Epidemiology Epidemiology • Significant variability across the world • Dramatically decreased in last decades • Birth trauma in 3% of all live births • Accounts for less than 2% of neonatal deaths • Even when the injuries are benign, birth trauma may result in significant anxiety for a family Disability adjusted life year (DALY): Measure of overall disease burden expressed as number of years lost due to ill-health, disability or early death Reichard R.